HIV感染和AIDS患者T淋巴细胞免疫病理改变的研究

T-lymphocyte immune in HIV-infected people and AIDS patients in China

目的 探讨我国HIV感染和AIDS患者T淋巴细胞的免疫病理改变情况及其临床意义。方法 收集 13例HIV感染患者 (HIV组 )、2 7例AIDS患者 (AIDS组 )和 5 1名健康献血员 (正常对照组 )的抗凝血 ,用人T淋巴细胞亚群的特异性荧光抗体标记 ,通过流式细胞仪检测外周血CD4 + T淋巴细胞 (T4细胞 )、CD8+ T淋巴细胞 (T8细胞 )及其亚群 ,并检测患者血浆HIV载量。结果 正常对照组、HIV组和AIDS组外周血T4细胞计数 (× 10 6个 /L)分别为 84 9± 2 88,4 37± 184 ,5 0± 5 1,组间比较P <0 0 1;T8细胞计数 (× 10 6个 /L)分别为 5 79± 175 ,10 31± 345 ,5 35± 338,HIV组明显高于正常对照组(P <0 0 5 ) ;T4纯真细胞 (CD4 + CD4 5RA+ CD6 2L+ )亚群比例分别为 4 3 0 %± 11 4 % ,4 4 2 %± 12 8% ,2 4 8%± 15 5 % ,AIDS组明显为低 (P <0 0 5 ) ;T4纯真细胞计数 (× 10 6个 /L)分别为 36 8± 16 2 ,185±134,18± 2 0 ,组间比较P <0 0 1;T4功能细胞 (CD4 + CD2 8+ )亚群比例分别为 93 1%± 8 1% ,6 2 6 %±2 8 2 % ,5 6 9%± 2 6 4 % ,组间比较P <0 0 1;T4和T8激活细胞 (CD4 + HLA DR+ ,CD8+ HLA DR+ ,CD8+CD38+ )亚群比例均表现为AIDS组 >HIV组 >正常对照组 (P <0 0 5 ) ;T4和T8凋亡细胞 (CD4 +CD95 + 。

Objective To study the T lymphocyte immune alterations and its clinical significance in HIV infected persons and AIDS patients in China Methods Peripheral blood samples were collected from 13 HIV infected persons, 27 AIDS patients, and 51 healthy blood donors (controls) and then labeled with monoclonal antibodies Flow cytometry was used to detect the count of CD4 + T lymphocytes, CD8 + T lymphocytes , and its different subsets including the naive cell subset (CD4 + CD45RA + CD62L +), activated cell subsets(CD4 + HLA DR +,CD8 + HLA DR +,CD8 +CD38 +), functional cell subsets (CD4 +CD28 +), and apoptotic cell subsets (CD4 +CD95 +,CD8 + CD95 +) The plasma HIV loading was also detected Results The CD4 + cell count was (849±288)×10 6/L in the control group,significantly higher than that in HIV infected person group [(437±184)×10 6/L, P <0 01], and that in AIDS patient group [(50±51)×10 6/L, P <0 01] The CD8 + cell count was (579±175)×10 6/L in the control group,significantly lower than that in HIV infected person group [(1 031±345)×10 6/L, P <0 05],and not significantly different from that in AIDS patient group (535±338)×10 6/L, with a significant difference between the HIV infected person group and AIDS patient group( P <0 05) The percentage of CD4 + CD45RA + CD62L + were 43 0%±11 4% in the control group, not significantly different from that in HIV infected person group (44 2%±12 8%), but significantly higher than that in AIDS patient group (24 8%±15 5%, P <0 05) The CD4 + CD45RA + CD62L + cell count was (368±162)×10 6/L in the control group,significantly higher than those in HIV infected person group [(185±134)×10 6/L] and in AIDS patient group [(18±20)×10 6/L, both P <0 01] with a significant difference between the HIV infected person group and AIDS patient group ( P <0 01) The percentage of CD4 +CD28 + was 93 1%±8 1% in the control group,significantly higher than those in HIV infected person group (62 6%±28 2%) and in AIDS patient group (56 9%±26 4%) with a significant difference between any two groups (all P <0 01) The percentages of CD4 +HLA DR +,CD8 +HLA DR +,and CD8 +CD38 + in the AIDS patient group were higher than those in the HIV infected person group and control group with significant difference between any two groups (all P <0 01) The percentages of CD4 +CD95 + and CD8 +CD95 + in the AIDS patient group were not significantly different from that in control group, but significantly higher than that in HIV infected person group ( P <0 05) The plasma HIV loading was 3 74±0 78 lg copies/ml in the HIV infected person group and was 4 94±0 68 lg copies/ml in AIDS patient group ( P <0 05),and the count of CD4 + cells and CD4 + CD45RA + CD62L + cells were obviously negatively correlated with the plasma HIV loading ( r =-0 796, r =-0 750, P <0 01) Conclusion The T lymphocyte immune dysfunction occurring in HIV infected persons and AIDS patients in China involves not only the number, but also the function and activation of T lymphocytes Synthetical analysis of the alterations of different T cell subsets reflects the immune deficiency and severity of disease more comprehensively than pure examination of the amounts of CD4 + and CD8 + cells